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Jefferson L Triozzi, MD, MSCI Profile picture
Jefferson L Triozzi, MD, MSCI
@nepherson
Nephrology fellow interested in chronic kidney disease research and Romanian deadlifting. Likes & Retweets ≠ Endorsements
Feb 25, 2021 • 18 tweets • 8 min read
1/18

Let’s talk vancomycin and the kidney.🧪

A 65 y/o woman on week 4 of IV vancomycin for ankle osteomyelitis presents with AKI (Cr 6.32mg/dL) and elevated vancomycin level (136 mg/dL).

What’s to blame?
#tweetorial #MedTwitter #Nephtwitter #FOAMed #TwitterRx @TheSkeletonKG 2/18

Vancomycin nephrotoxicity is a challenging diagnosis because elevated vanc levels may be the cause and/or the effect of acute kidney injury.

Vanc nephrotoxicity is a diagnosis of exclusion based on:
◼️AKI
◼️Elevated vanc level
◼️No more likely explanation
May 12, 2020 • 22 tweets • 7 min read
1a/14

It’s 1:34 p.m. and the ED pages you for hyponatremia. 📟

A 45 y/o M with no known medical history presents after a seizure with a sodium of 102 mEq/L.

#tweetorial #MedTwitter #Nephtwitter #hyponatremia @theskeletonkeygroup

What's your first move? 1b/14

The initial evaluation of hyponatremia must “evaluate osmolality excluding hyperglycemia and other causes of non-hypotonic (SOsm >275) hyponatremia.” - per the European Guidelines (PMID: 24569125) 🇪🇺🇪🇺🇪🇺

We find a hyperosmolar hyponatremia: